Unformatted text preview: scalpeled and hormoned
Lenore—a 46,XY person—into a girl. With the hormones given her,
Lenore’s facial hair cleared up and her breasts began to grow, gracing her
chest with one of the most noticeable badges of womanhood.1
But of course none of this really solved the problem, if in fact there
ever was a problem that needed solving. In the end, to some Lenore was The Puzzle of Intersex 7 clearly a girl. At the same time, to others Lenore remained a boy. But
Lenore was neither.
What, then, should we call Lenore?
Dr. Betty Suits Tibbs’s report ends with Lenore in the tenth grade—
maybe sixteen years old. Dr. Tibbs observed, “The patient is in tenth
grade at present and has made a very good adjustment. It is felt that
with her drive and capacities, the prognosis for her identity as a woman
is quite good.” The rest of Lenore’s story we can only imagine.
Every year in the United States, approximately one thousand babies
are born with cystic fibrosis and about four hundred are born with
hemophilia. Few of us have to ask what hemophilia or cystic fibrosis
are. We might not fully understand what causes these disorders, but we
know that either one can make a person’s life very difficult. Curiously,
no one seems to know just how many babies of indeterminate sex like
Lenore are born in the United States every year. Estimates range from
one thousand to fifteen thousand. It seems probable that the correct
number is nearer to the lower estimate than the higher one. Regardless, it is a substantial number of people. We now refer to these people
collectively as intersex, or people with disorders of sex development
(DSDs). The birth of an intersex child is a difficult event for family
and physicians. They must select, from very few options, the least-bad
alternative with the hope that, even in their ignorance, even with the
paucity of language available to speak about these children, even under
the weight of history and fear, they may create a better future for their
Surprisingly, until very recently, standard practice usually excluded
the child and the parents from the decision-making process. The physicians made the choice of boy or girl and did what they could do to
ensure that the child would walk that path for the rest of his or her life.
Physicians believed they knew best and that the input of others was
unnecessary. They believed that the fewer who knew about what had
happened at birth, the less likely it was that someone might raise the
veil so carefully woven and placed by their hands. 8 Between XX and XY As a result, for years hardly anyone outside the medical community
had heard of the thousands upon thousands of children like Lenore.
And even today, most of us hear little about these people who, like
Lenore, fall through the cracks in our language and raise serious questions about our cast-iron ideas about two opposite sexes. Maybe we
don’t hear much about these people simply because we don’t want to
hear about them. They make us even more uneasy about things we are
already sufficiently uneasy about—things like human sex. But regardless of our discomfort, these are people, and their stories are important,
because wrapped up inside of them is a secret that all of us should
know, a secret about what it truly means to be human. 2
A Brief History of Sex In many ways Lenore’s future was laid out years before she was born. As
Dr. Brown and his colleagues pondered Lenore’s situation, millennia of
human thought about sex and intersex molded their ideas. As long as
human beings have walked upright, we’ve been thinking about how we
acquire sex, how we have sex, and why we need sex. And though most
of us may believe that humans have always thought in more or less the
same ways about the sexual character of human beings, history doesn’t
support that assumption. In fact, we have not even always believed that
humans come in two, and only two, opposite sexes.
Ancient Greek Sex (c. 450 B.C.–A.D. 200): The Power of One
Our access to musings about the biology of human sex begins about
twenty-four hundred years ago with people like Hippocrates (c. 460–c.
377 B.C.), Aristotle (384–322 B.C.), and Galen (A.D. 129–c. 199). Hippocrates, the father of medicine, forced the first separation of religion
and science. He argued for the natural origins of disease and death
and shunned the gods. He was a logical man and a careful observer of
humankind. Nothing he proposed originated from fancy or spur-of-themoment decisions. He was thorough and methodical. 9 10 Between XX and XY Hippocrates proposed that menstrual blood and sperm were in
essence the same substance. Women shed menstrual blood, he said,
when an excess of nutrients accumulated in the blood. Men, instead,
refined blood foam into sperm and passed it along to the brain. The
sperm then made its way through the spinal marrow, into the kidneys,
to the testicles, and finally into the penis itself. Hippocrates clearly saw
differences between men and women, but for him the diffe...
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This document was uploaded on 02/04/2014.
- Spring '14